Clinical Features of Late-onset Ankylosing Spondylitis: Comparison with Early-onset Disease

The Journal of Rheumatology, 04/09/2012

Montilla C et al. – The study suggests that age at onset of AS affects the patients’ presenting clinical form. Arthritis of the upper limbs requires a differential diagnosis with other conditions frequent in patients over 50 years of age, such as rheumatoid arthritis or crystal–induced arthropathy.

Methods

The authors studied late–onset AS in the National Registry of Spondyloarthritis of the Spanish Society of Rheumatology (REGISPONSER database) cohort (n = 1257), of whom 3.5% had onset at age ≥ 50 years versus a control group with onset at < 50 years.

Results

There were no differences between late–onset and early–onset AS according to sex and family history of spondyloarthropathies.

Patients in the late–onset group more often showed involvement of the cervical spine (22.7% vs 9.7%; p = 0.03) and arthritis of the upper (13.6% vs 3.0%; p = 0.002) and lower limbs (27.3% vs 15.2%; p = 0.03) as first manifestations than did patients in the early–onset group.

A higher percentage of mixed forms (axial and peripheral joint disease) during the course of the disease was also recorded in the late–onset group (50% vs 24%; p = 0.0001).